- Erin Basinger thought she had a swollen armpit and was tired because she was a new mom.
- She thinks fatphobia delayed her stage 4 cancer diagnosis.
- Fat pregnant patients receive negative messages from clinicians, including that they’re bad moms.
When Erin Basinger went wedding dress shopping in 2019, she struggled to find bras that would accomodate the growing mass under her armpit, and dresses that wouldn’t accentuate it.
So she bought a wireless bra and a looser-fitting dress, and tried to push her concerns about the lump aside. After all, she’d always had some fatty tissue in that area and had recently undergone surgery for carpal tunnel syndrome. Perhaps, she thought, the procedure had prompted some fat redistribution or swelling.
Even when it continued to grow during and after her first pregnancy in 2020, Basinger chalked it up to hormones. She’d attended the standard prenatal and postpartum visits, and the doctor hadn’t raised any concerns.
Basinger, now 36, had been battling extreme fatigue too — “scream-singing” to keep her eyes open in the car, and pulling over to nap when that failed. Still, she figured, that’s what pregnancy and new parenthood must be like.
But more than six months postpartum, the mass had grown to the size of a grapefruit. After consulting with her sister, a nurse, Basinger visited a new doctor to specifically ask about the lump in December 2021.
A few tests and referrals later, she was diagnosed with stage 4 non-Hodgkin’s lymphoma. She had an aggressive subtype that had spread to her head, neck, chest, abdomen, pelvis, and parts of her bones.
“My PET scan lit up like a Christmas tree,” she said. “It was terrifying in general, and for me it was terrifying because I had a seven-month-old.”
She shared her story — including how she thinks weight stigma played a role in her delayed diagnosis — with Insider to encourage women to advocate for themselves, and to validate pregnant patients who also feel they have been overlooked, if not downright ridiculed, for their weight.
“I want other people to know: I’m fighting for you, even if you feel like you can’t fight for yourself,” she said.
Basinger suspects doctors dismissed the lump as ‘just fat’
Basinger, a communications professor for the University of North Carolina Charlotte’s health psychology graduate program, wishes she had better advocated for herself when she first thought something was off. “That’s my biggest regret,” she said.
But she also can’t help but think weight stigma contributed to her delayed diagnosis. “When I look back, I think maybe that was incompetence,” she said. “I suspect there was also probably some fatphobia there, like, ‘She’s fat, so this is probably just fat.'”
She has a lifetime of anecdotes to back that suspicion up. Doctors chalked up her rheumatoid arthritis to fatness, for example, and said her request to be tested for PCOS was just an “excuse” for her size.
“Every time I went to the doctor, it was like, ‘Well it’s probably because of your weight,'” she said. “And it’s like, ‘I think if I hurt my elbow, it’s just because I hurt my elbow.'”
That didn’t change before or during her pregnancy. When she got her IUD removed, the OB-GYN warned her that infertility and pregnancy loss were likely. “Her words were really just a dark cloud over my pregnancy because I was constantly afraid that I was going to miscarry,” Basinger said.
Doctors also told her that if she gained more than 19 pounds while pregnant, she’d have to leave the state-of-the-art practice where she was being monitored to deliver at a poorly rated hospital because it had a NICU.
“It just felt like this consequence hanging over my head,” Basinger said.
Weight stigma can contribute to worse outcomes in fat pregnant patients
While there are links between bigger bodies and pregnancy complications, it’s unclear how much of that is physiological (fat affecting how hormones are stored) versus structural (ultrasounds not working well on larger bodies or clinicians not trained in delivering anesthesia to people with more fatty tissue).
Confounding issues like an increased risk of gestational diabetes in higher-weight moms-to-be play a role too.
Generally, health behaviors — how you eat, move, sleep, and manage stress, for example — are better indicators of health than size, pregnant or not, evidence suggests.
But healthcare providers often emphasize a pregnant person’s weight above all else, leading to guilt and shame, which is health-diminishing itself, research shows.
In her October 2022 study, conducted with UNC colleagues Margaret M Quinlan and Margaret Rawlings, she surveyed 237 fat people about the messages they received before, during, and after pregnancy. They found the most memorable messages came from healthcare providers, and the vast majority of those messages were negative.
For instance, clinicians insinuated that fat moms are bad moms, and that it’s their fault medical equipment isn’t made for their bodies.
Some pregnant people also reported being denied fertility treatments or care from midwives based on their size. “That is openly saying: ‘We don’t think you deserve to reproduce at your size,’ or, ‘You body is not capable of doing this naturally,'” Basinger said.
Others said weight-loss during pregnancy was praised, despite its dangers, and that they were encouraged to breastfeed to lose weight — not because of its benefits to the baby. One participant said her doctor blamed her size for her pregnancy loss.
These direct and indirect messages aren’t just hurtful, they can exacerbate mental and physical health issues in fat pregnant patients. One study found weight stigma in pregnancy was linked to worse healthcare treatment, mental health symptoms, poorer health behaviors, and negative pregnancy outcomes.
In one extreme example, a participant in Basinger’s survey said her stillbirth was related to weight stigma. When the external monitor stopped working during labor, she said clinicians assumed it was due to her size rather than malfunctioning equipment, and didn’t work to fix it. When a nurse finally helped, she said, “My baby was dead.”
Basinger went through six rounds of chemotherapy while a mom to an infant
After her cancer diagnosis, she went through six rounds of chemotherapy, which, she said, was “horrific.”
She’s now in remission, and grateful for her hematologist who focused on treating her cancer — not discussing her weight.
“I do not often have incredible experiences with doctors, so I’m very thankful to have gotten competent care with him because he saved my life in a very literal way,” she said.
She hopes sharing her and others’ experiences can inspire more doctors like him. In the meantime, she encourages fat moms-to-be to seek weight-inclusive clinicians and to combat stigma by educating themselves with books like “Fat and Fertile.”
“It was so comforting to me to find those resources and know my body is powerful and beautiful and can bring a healthy baby into the world,” Basinger said. “And I did, contrary to what my doctors told me would happen. I had a beautiful baby boy who is just the light of my life.”